Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The plant Cannabis sativa has a long history of medical use in the treatment of pain and spasms, the promotion of sleep, and the suppression of nausea and vomiting. However, in the early 70s cannabis was classified in the Narcotic Acts in countries all over the world as having no therapeutic benefit; therefore, it cannot be prescribed by physicians or dispensed by pharmacists. In the light of this contradictory situation an increasing number of patients practices a self-prescription with cannabis products for relieving a variety of symptoms. An anonymous standardized survey of the medical use of cannabis and cannabis products of patients in Germany, Austria and Switzerland was conducted by the Association for Cannabis as Medicine (Cologne, Germany). During about one year 170 subjects participated in this survey; questionnaires of 128 patients could be included into the evaluation. 68% of these participants were males, 32% females, with a total mean age of 37.5 (+/- 9.6) years. The most frequently mentioned indications for medicinal cannabis use were depression (12.0%), multiple sclerosis (10.8%), HIV-infection (9.0%), migraine (6.6%), asthma (6.0%), back pain (5.4%), hepatitis C (4. 8%), sleeping disorders (4.8%), epilepsy (3.6%), spasticity (3.6%), headache (3.6%), alcoholism (3.0%), glaucoma (3.0%), nausea (3.0%), disk prolapse (2.4%), and spinal cord injury (2.4%). The majority of patients used natural cannabis products such as marihuana, hashish and an alcoholic tincture; in just 5 cases dronabinol (Marinol) was taken by prescription. About half of the 128 participants of the survey (52.4%) had used cannabis as a recreational drug before the onset of their illness. To date 14.3% took cannabis orally, 49.2% by inhalation and in 36.5% of cases both application modes were used. 72.2% of the patients stated the symptoms of their illness to have 'much improved' after cannabis ingestion, 23.4% stated to have 'slightly improved', 4.8% experienced 'no change' and 1.6% described that their symptoms got 'worse'. Being asked for the satisfaction with their therapeutic use of cannabis 60.8% stated to be 'very satisfied', 24.0% 'satisfied', 11.2% 'partly satisfied' and 4.0% were 'not satisfied'. 70.8% experienced no side effects, 26.4% described 'moderate' and 3.3% 'strong' side effects. 84.1% of patients have not felt any need for dose escalation during the last 3 months, 11.0% had to increase their cannabis dose 'moderately' and 4.8% 'strongly' in order to maintain the therapeutic effects. Thus, this survey demonstrates a successful use of cannabis products for the treatment of a multitude of various illnesses and symptoms. This use was usually accompanied only by slight and in general acceptable side effects. Because the patient group responding to this survey is presumably highly selected, no conclusions can be drawn about the quantity of wanted and unwanted effects of the medicinal use of the hemp plant for particular indications.
 ...
PMID:[Results of a standardized survey on the medical use of cannabis products in the German-speaking area]. 2146 33

We report the case of a 33 year old Thai female, who was married in Germany for eight years and used to travel to Thailand every year for several weeks. She presented with abdominal and back pain, prolonged fever, generalized lymphadenopathy, and a recent history of oral thrush. She was diagnosed HIV positive with initial CD4 counts of 18/microliter and an HI virus load of 59,000 copies/ml. Antiviral therapy was installed with zidovudin, lamivudin, and efavirenz. Abdominal CT scans revealed greatly enlarged abdominal lymph nodes. Fine needle aspirates of cervical and retroperitoneal lymph nodes, sputum samples, blood samples, and a bone marrow biopsy were microscopically positive for Penicillium marneffei and grew P. marneffei. The isolates were sensitive to amphotericin B, flucytosine, itraconazole, and fluconazole. Both universal and specific fungal polymerase chain reaction assays were positive in various samples. Serum Aspergillus galactomannan antigen, which is known to crossreact with P. marneffei, was elevated and subsequently used for monitoring of therapy. With antifungal treatment (intravenous amphotericin B 0.6 mg/kg/d for two weeks, oral itraconazole 400 mg/d for 10 weeks and 200 mg/d as maintenance therapy), the fever declined in 6 days, the size of the enlarged lymph nodes gradually decreased in the CT scans, and the initial abdominal and back pain vanished.
 ...
PMID:Disseminated Penicillium marneffei infection in an HIV-positive female from Thailand in Germany. 1086 99

At a recent seminar on pain management in Atlanta, researchers reported that health care providers do poorly when it comes to recognizing and managing the pain suffered by patients with AIDS. This lack of adequate attention is reflected in the lack of relevant studies about pain management in the medical literature. As with cancer, AIDS pain increases with disease progression. However, patients with AIDS tend to be more depressed than cancer patients, and have a higher rate of suicidal thoughts. Experts at the seminar discussed the obstacles involved in treating pain in AIDS patients who have a history of substance abuse. According to one study, pain medication addiction is rare in patients. Providers must distinguish between tolerance and physical dependence. Guidelines for managing pain in substance abusers include respecting the patient's reports of pain, and setting clear goals and conditions for opioid therapy. Using a team approach that recognizes pharmacological and non-pharmacological interventions, and that pays attention to psychosocial issues will also lead to greater success in treating patients with pain. The most common painful illnesses are HIV-related headaches, herpes simplex, peripheral neuropathy, back pain, herpes zoster, and throat pain.
 ...
PMID:Clinicians not providing necessary pain relief for AIDS patients. 1136 81

Doctors recently identified a new form of parasitic worm that was associated with the death of a person with AIDS from the San Francisco Bay area about 1 year ago. The man acquired HIV 5 years ago, but was hospitalized in 1994 with stomach and back pain, weight loss, night sweats and fever. After the worm destroyed parts of the liver and intestines, doctors suspected a new variety of HIV-related cancer. Upon examining the tissue using polymer chain reaction technology, the doctors were able to see that the large amount of scar tissue was caused by the fast growth of the worm. Many questions remain unanswered, such as: how often the new worm causes disease in humans, whether the weakened immune system of a person with AIDS was a factor in susceptibility, where the microbe exists in nature, and whether the infestation can be treated effectively using drugs known to be effective against similar parasites.
 ...
PMID:Lethal new worm discovered in PWA. 1136 26

Spinal epidural abscess (SEA) due to Streptococcus pneumoniae is rare and has never been reported in an HIV-infected patient, despite the higher risk of invasive disease in this group. We describe here the first case of pneumococcal epidural abscess, presenting with fever and back pain in a 60-year-old man infected with HIV. Blood cultures were positive for S. pneumoniae and magnetic resonance imaging (MRI) confirmed the suspicion of diskitis and SEA at the L4-S1 level. The patient was successfully treated with iv ceftriaxone without surgical intervention. The clinical characteristics of this case are compared with existing literature on pneumococcal SEA.
 ...
PMID:Spinal epidural abscess due to Streptococcus pneumoniae in an HIV-infected adult. 1154 88

Various hematologic malignancies and solid tumors are increasingly diagnosed in patients with human immunodeficiency virus (HIV) infection and may be the presenting manifestation of acquired immunodeficiency syndrome (AIDS). Multiple myeloma, however, has never been reported as the presenting manifestation of AIDS. We report on a 34-year-old man who presented with back pain, paresthesias, paraparesis, vertebral bony disease, and an associated soft tissue mass. Biopsy of the mass revealed immature plasmacytes with very faint cytoplasmic expression of kappa light chains. Bone marrow biopsy revealed 25% infiltration with poorly characterized malignant cells and 15% polyclonal plasma cells. Immunofixation of serum and urine was positive for IgG kappa and kappa light chains, respectively. A bone survey revealed lesions in the skull, left femur bone, and the pelvis. The diagnosis of an anaplastic myeloma was made. Because of the poorly characterized nature of the malignant cells and the difficulties in immunophenotyping, serologic evaluation for HIV was undertaken and was positive. The concept of myeloma as an opportunistic neoplasm defining AIDS was considered. We discuss this view and recommend that patients with multiple myeloma with poorly characterized myeloma cells as well as difficulties in immunophenotyping should undergo testing for HIV infection.
 ...
PMID:Multiple myeloma as the first manifestation of acquired immunodeficiency syndrome: a case report and review of the literature. 1166 9

Tuberculosis is a common disease in Africa, Asia, and South America. In Denmark the incidence is 10/100,000 and highest in HIV positive patients, alcoholics, and some immigrant groups. We describe a young Dane, who was referred to the department of rheumatology for back pain. It turned out to be tuberculosis spondylitis with a major psoas abscess.
 ...
PMID:[Tuberculous spondylitis with a psoas abscess in a young man without an immigrant background]. 1241 77

A female patient with multiple osteomyelitis and pulmonary Mycobacterium avium disease visited an orthopaedic clinic with back pain. Systemic bone scan showed multiple sites of increased radioactivity in the vertebral bodies, right scapula, femurs and ribs. M. avium was isolated from sputum and a sample aspirated from the right scapula. The route of infection was unknown as there was no history of trauma or surgery. HIV testing was negative. As there was no underlying immunological disease she was diagnosed as disseminated M. avium complex (DMAC) disease in an immunocompetent adult. Cytokine production on several stimuli from peripheral blood mononuclear cells was similar to that in pulmonary M. avium patients. Sequence analysis of IFN-gamma receptor revealed no nucleotide substitution. We detected serotypes 1, 2 and 4 from mycobacteria cultured from the right scapula, and conclude that this case could be the result of undetected immune deficiency and/or unrecognised virulence of the infecting isolate.
 ...
PMID:Disseminated Mycobacterium avium complex (DMAC) in an immunocompetent adult. 1275 54

PRESENTING FEATURES: An 18-year-old white man was admitted to the Osler Medical Service with the chief complaint of back pain. Two weeks prior to admission, the patient developed diffuse and aching upper back pain. Over the next couple of days, he also developed severe anterior chest pain that was somewhat pleuritic in nature but diffuse and extending bilaterally into the shoulders. One week prior to admission, he developed intermittent fevers and night sweats. The patient denied any lymphadenopathy, pharyngitis, sick contacts, shortness of breath, rash, or bleeding. He was seen by a physician and told that he had thrombocytopenia. There was no history of recent or remote unusual bleeding episodes. His medical history was unremarkable except for a childhood diagnosis of attention deficit/hyperactivity disorder. He was not taking any medications and had no history of tobacco, alcohol, or illicit drug use. He had no risk factors for human immunodeficiency virus infection. Physical examination showed that he was afebrile and had normal vital signs. He was a well-appearing man who was lying still because of pain. HEENT examination was unremarkable. There was no pharyngeal erythema or exudates. His lungs were clear. His neck was supple and without lymphadenopathy. Examination of his back and chest revealed no focal tenderness. There was no hepatosplenomegaly, and his skin was without petechiae or rashes. Examination of the patient's joints showed pain on passive and active movement of his shoulders bilaterally, but no frank arthritis. There was no rash, petechiae, or echymoses. Chest radiograph and electrocardiogram were unremarkable. On admission, the laboratory examination was notable for a hematocrit level of 32.5%, with a mean corpuscular volume of 79 fL, and white blood cell count of 2.8 x 10(3)/microL. Platelet count was 75 x 10(3)/microL. A white blood cell differential revealed 7% bands, 53% polys, 34% lymphs, 5% atypical lymphocytes, 2% nucleated red cells, and a few young unidentified cells. His chemistry studies were unremarkable. What is the diagnosis?
 ...
PMID:Cases from the Osler Medical Service at Johns Hopkins University. 1521 Mar 89

Patients with HIV can often present a diagnostic challenge and may have atypical presentations of more common diseases. This case demonstrates such a scenario; we describe a 35-year-old man with a recent diagnosis of HIV infection complaining of backache, anorexia and weight loss. On investigation he was found to have bilateral tuberculous psoas abscesses. A review of the literature shows that this is a rare presentation of an already unusual problem, with subtle signs requiring a high index of clinical suspicion. However, with HIV-positive patients more likely to present with extrapulmonary tuberculosis, there is need for increased awareness of this diagnosis.
 ...
PMID:Bilateral psoas abscesses in an HIV-positive patient. 1560 93


<< Previous 1 2 3 4 5 Next >>